TNCC Shock and Fluid Resuscitation 3

Question 1

The base deficit on an arterial blood gas is a useful marker in trauma because it indicates:

Accepted Answer

The severity of tissue oxygen debt and anaerobic metabolism

Answer

Base deficit reflects the degree of metabolic acidosis from tissue hypoperfusion and anaerobic metabolism, serving as a surrogate marker for the severity and duration of shock.

Question 2

Which vasopressor is preferred as a first-line agent for trauma patients who remain hypotensive despite adequate volume resuscitation?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the preferred first-line vasopressor in trauma-related shock (after adequate volume resuscitation) due to its balanced alpha-1 and beta-1 effects, providing vasoconstriction and inotropy.

Question 3

A patient with Class III hemorrhagic shock (30-40% blood volume loss) would be expected to present with which combination of findings?

Accepted Answer

Tachycardia 120-140, hypotension, tachypnea 30-40, confused and anxious

Answer

Class III hemorrhage (1,500-2,000 mL, 30-40% blood volume) presents with significant tachycardia, the first measurable drop in systolic blood pressure, marked tachypnea, and confusion.

Question 4

Point-of-care viscoelastic testing (TEG/ROTEM) during trauma resuscitation is used to:

Accepted Answer

Guide goal-directed component therapy by assessing clot formation, strength, and breakdown in real-time

Answer

TEG (thromboelastography) and ROTEM (rotational thromboelastometry) provide real-time viscoelastic analysis of clot formation, strength, and fibrinolysis, enabling targeted blood component therapy.

Question 5

Hypothermia in trauma patients worsens hemorrhage primarily by:

Accepted Answer

Impairing coagulation enzyme function and platelet aggregation

Answer

Hypothermia impairs the enzymatic reactions of the coagulation cascade and reduces platelet adhesion and aggregation, significantly worsening hemorrhage.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC Shock and Fluid Resuscitation 3